Provider Demographics
NPI:1811210842
Name:PATEL, KRUNAL A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRUNAL
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-4902
Mailing Address - Country:US
Mailing Address - Phone:619-441-8040
Mailing Address - Fax:
Practice Address - Street 1:1299 BROADWAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4902
Practice Address - Country:US
Practice Address - Phone:619-441-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11362183500000X
NC18484183500000X
AZS022935183500000X
CA80338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist